| NPI | 1104985498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: SC 7633) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT008867) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2015-10-20 |